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Huang J, Huang C, Chen J, Huang K. Perception of clinical teachers about their roles and current practice at affiliated hospitals of medical universities in China. MEDICAL EDUCATION ONLINE 2024; 29:2325182. [PMID: 38465652 DOI: 10.1080/10872981.2024.2325182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/26/2024] [Indexed: 03/12/2024]
Abstract
Phenomenon: The increase in clinical and teaching workload has brought enormous pressure to clinical teachers. Clinical teachers play an extremely important role in the quality of higher medical education and the cultivation of medical talents. However, few studies have examined the attitudes and practices of clinical teachers regarding the role of teachers in China. This study aimed to investigate clinical teachers' perceptions about their roles and current practices at affiliated hospitals of medical universities in China. Approach: Responses from 312 Chinese clinical teachers were included in the analyses. The data were collected using the questionnaires of perception and practice regarding the role of teachers which consisted of 12 items rated on a 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree), and scored by calculating the mean. The data were analyzed using the Statistical Package for Social Sciences, version 22.0 (IBM SPSS Corp). Findings: The mean score of perception of clinical teachers regarding the role of teachers was 4.51 (SD = 0.72), and the mean score of practice was 3.69 (SD = 1.17). Multivariable binary logistic regression model showed that undertaking very few/few clinical teaching workload, 'thinking it is my obligation to carry out teaching work seriously' and 'thinking it is my duty to train medical talents' were not only significant determinants of good perception but also good practice. Additionally, 'thinking hospital attached great importance to clinical teaching' was the significant determinant of good perception. Insights: Chinese clinical teachers demonstrate less positive perception and practice regarding the roles of teacher than clinical teachers in developed countries. Affiliated hospitals of medical universities should hold training sessions regularly and take targeted intervention measures to enhance clinical teachers' perception and practice regarding the roles of teacher.
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Affiliation(s)
- Jinmeng Huang
- Educational Evaluation and Faculty Development Center, Guangxi Medical University, Nanning, Guangxi, China
| | - Chunxia Huang
- School of Foreign Languages, Guangxi Medical University, Nanning, Guangxi, China
| | - Jinmei Chen
- Educational Evaluation and Faculty Development Center, Guangxi Medical University, Nanning, Guangxi, China
| | - Kaiyong Huang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Key Laboratory of Environment and Health Research, Guangxi Medical University, Nanning, Guangxi, China
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2
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Rösch RM, Griffo R, Berger-Groch J, Brendel L, Presotto MA, Metelmann I, Winter H, Klotz LV. [Deficit of trainees in thoracic surgery : Do we need to adapt or become extinct?]. CHIRURGIE (HEIDELBERG, GERMANY) 2024:10.1007/s00104-024-02106-w. [PMID: 38819686 DOI: 10.1007/s00104-024-02106-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/03/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Although thoracic surgery is a challenging and versatile surgical specialty, a shortage of qualified and motivated thoracic surgery residents is expected in the coming years. In the inpatient setting, a shortage of approximately 7300 surgeons is expected. Therefore, there is an urgent need to attract more interested young medical students and improve the medical training of our next generation of surgeons. METHODS To assess the current nationwide status quo among medical students, an online survey with 39 questions on participant demographics, medical education, interest in surgical and thoracic surgery training, and attractiveness of residency was designed. RESULTS In all, 224 questionnaires were analyzed. Overall, there was a high level of interest in (thoracic-) surgery at the start of training. It should be noted that one third of the respondents did not know that the 'thoracic surgeon' is an independent specialist. This statement raises further questions about the presence of thoracic surgery in medical studies. When asked about typical characteristics that students associate with thoracic surgery, the majority answered 'a high level of practical activity'. The main reason they gave for not pursuing further surgical training was the unfavorable work-life balance. CONCLUSION Students know exactly what they want for their future and where surgery has its weaknesses. They want transparent and practical training, a work-life balance, and recognition of their work and themselves.
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Affiliation(s)
- Romina Maria Rösch
- Abteilung für Thoraxchirurgie, Thoraxklinik Heidelberg, Röntgenstr. 1, 69126, Heidelberg, Deutschland.
- Deutsches Zentrum für Lungenforschung - Zentrum für Translationale Lungenforschung (TLRC), Universitätsklinikum Heidelberg, Neuneheimer Feld 130.3, 69120, Heidelberg, Deutschland.
| | - Raffaella Griffo
- Abteilung für Thoraxchirurgie, Thoraxklinik Heidelberg, Röntgenstr. 1, 69126, Heidelberg, Deutschland
- Deutsches Zentrum für Lungenforschung - Zentrum für Translationale Lungenforschung (TLRC), Universitätsklinikum Heidelberg, Neuneheimer Feld 130.3, 69120, Heidelberg, Deutschland
| | - Josephine Berger-Groch
- Abteilung für Orthopädie, Rehaklinik Sonnhalde, Am Schellenberg 1, 78166, Donaueschingen, Deutschland
| | - Lena Brendel
- Abteilung für Thoraxchirurgie, Thoraxklinik Heidelberg, Röntgenstr. 1, 69126, Heidelberg, Deutschland
| | - Maria Ada Presotto
- Abteilung für Pneumologie, Thoraxklinik Heidelberg, Röntgenstr. 1, 69126, Heidelberg, Deutschland
| | - Isabella Metelmann
- Klinik und Poliklinik für Viszeral-, Transplantations-, Thorax- und Gefäßchirurgie, Universitätsklinikum Leipzig, Liebigstraße 20, 04103, Leipzig, Deutschland
| | - Hauke Winter
- Abteilung für Thoraxchirurgie, Thoraxklinik Heidelberg, Röntgenstr. 1, 69126, Heidelberg, Deutschland
- Deutsches Zentrum für Lungenforschung - Zentrum für Translationale Lungenforschung (TLRC), Universitätsklinikum Heidelberg, Neuneheimer Feld 130.3, 69120, Heidelberg, Deutschland
| | - Laura Valentina Klotz
- Abteilung für Thoraxchirurgie, Thoraxklinik Heidelberg, Röntgenstr. 1, 69126, Heidelberg, Deutschland
- Deutsches Zentrum für Lungenforschung - Zentrum für Translationale Lungenforschung (TLRC), Universitätsklinikum Heidelberg, Neuneheimer Feld 130.3, 69120, Heidelberg, Deutschland
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Chan PK, Wang YC, Huang SC, Chang YW. Learning through connections: clinical participation and interpersonal relationships in longitudinal integrated clerkships and traditional block rotations in Taiwan. BMC MEDICAL EDUCATION 2024; 24:132. [PMID: 38341547 PMCID: PMC10859009 DOI: 10.1186/s12909-024-05120-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 01/31/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Longitudinal integrated clerkships (LICs) and traditional block rotations (TBRs) employ different designs that provide various learning experiences for students. In this study, we explored students' clinical participation and interpersonal interactions in LICs and TBRs at 2 metropolitan hospitals in Taiwan. METHODS In April 2018, we enrolled 15 LIC and 29 TBR students. We conducted a cross-sectional survey which required the students to outline a typical daily schedule during their internal medicine rotations and draw an ecomap of the clinical team members. With the patient in the center as a reference, the size of each circle in an ecomap indicated the importance of the member; the distances and number of connecting lines between two circles represented the relationship and frequency of interaction, respectively, between the corresponding members. We analyzed the results and compared the responses of the LIC and TBR students. RESULTS The LIC students spent more time on direct patient care and in the outpatient clinic/operation room, whereas the TBR students participated more in educational activities and in observation behind their seniors. In the ecomap analysis, the LIC students had a closer relationship with attending physicians and had better interactions with patients and preceptors than did the TBR students. Conversely, the TBR students felt closer to and interacted more frequently with interns and residents. CONCLUSIONS The LIC students had more opportunities to care for patients directly and engaged in interactions with patients and attending physicians more frequently than did the TBR students. TRIAL REGISTRATION Ethical approval for the study was obtained from the Institutional Review Board of Tri-Service General Hospital (TSGHIRB 2-106-05-018).
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Affiliation(s)
- Po-Kai Chan
- Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yung-Chih Wang
- Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri- Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Shih-Chung Huang
- Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Yaw-Wen Chang
- Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Gong Rd., Neihu Dist, Taipei City, 11490, Taiwan.
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Pålsson P, Hulegårdh E, Wahlqvist M, Naredi S, Jood K. Physicians' self-perceived preparedness for clinical supervision of medical students at university and non-university hospitals -results from a Swedish survey. BMC MEDICAL EDUCATION 2023; 23:914. [PMID: 38049767 PMCID: PMC10694957 DOI: 10.1186/s12909-023-04908-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 11/28/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND The need for clinical placements outside traditional teaching hospitals for medical students is growing, both due to a decrease in hospital beds and the expansion of medical students. In this survey, distributed to supervisors at university and non-university hospitals, we investigated supervisors' self-perceived preparedness for the training assignment and searched for factors associated with self-perceived pedagogical knowledge and familiarity with the students' learning objectives. METHODS A pilot survey was developed using results from qualitative studies regarding clinical supervision of medical students and included questions on the supervisors' education and preparation, if they were familiar with the students' learning objectives, self-perceived pedagogical knowledge, and characteristics of the learning environment. The pilot survey was tested on a smaller group of supervisors. The results from the pilot survey were used to develop an e-survey that was distributed to all hospital employed physicians in Region Västra Götaland. RESULTS The survey was completed by 1732 physicians (response rate 43%). Among 517 respondents at the university hospital who reported activity as supervisor, 240 (46%) had attended preparatory supervisor training, 423 (82%) perceived enough pedagogical knowledge for the teaching assignment, and 391 (76%) reported familiarity with the learning objectives. The corresponding proportions at non-university hospitals were 159/485 (33%), 363/485 (75%), and 298/485 (61%), respectively (p ≤ .007 all through, compared to the university hospital). Perceiving that goal description and written information from the course management was sufficient for being able to complete the training assignment showed strong association with both self-perceived pedagogical knowledge and familiarity with the students' learning objectives. CONCLUSIONS We found consistent differences between university and non-university hospitals with respect to the supervisors' self-perceived preparedness for the training assignment. Efforts to convey the learning objectives and support to clinical supervisors are crucial for supervision of students at non-university hospitals.
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Affiliation(s)
- Paul Pålsson
- Department of Education, Region Västra Götaland, NU-hospital group, Trollhättan, 46185, Sweden.
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Erik Hulegårdh
- Department of Research, Region Västra Götaland, Sahlgrenska University Hospital, Development, Education and Innovation, Gothenburg, Sweden
| | - Mats Wahlqvist
- Department of Research, Region Västra Götaland, Sahlgrenska University Hospital, Development, Education and Innovation, Gothenburg, Sweden
| | - Silvana Naredi
- Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Katarina Jood
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Neurology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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Jordan J, Amen A, Do AK, Osborne A, Weygandt PL, Moore KG. RaT race: A standardized open-access education resource provides a structured resident-as-teacher experience. AEM EDUCATION AND TRAINING 2023; 7:e10913. [PMID: 37817837 PMCID: PMC10560752 DOI: 10.1002/aet2.10913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 10/12/2023]
Abstract
Objectives There is no unified approach for training residents to be teachers. Foundations of Emergency Medicine (FoEM) is a national program that provides free resident education in emergency medicine (EM) utilizing small-group, case-based instruction delivered by individual program faculty and residents. This study seeks to explore the FoEM resident-as-teacher (RaT) experience. Methods We conducted a mixed-methods study of FoEM faculty site leaders and resident teachers in 2022. Site leaders completed an online survey consisting of multiple-choice, completion, and free-response items. We calculated descriptive statistics and applied a thematic qualitative analysis to free-response items. We conducted semistructured interviews with resident teachers. Interview transcripts were analyzed using a thematic approach with a constructivist-interpretivist paradigm. Results A total of 133 of 180 (74%) site leaders completed the survey and 11 resident teachers were interviewed. Forty-nine (37%) programs utilize resident instructors. The frequency of residents teaching and degree of faculty supervision varied. Commonly identified advantages include reinforcement of core content for resident teachers (44/49), structured format (35/49), and reduced need for faculty instructors (30/49). The most commonly identified challenges include variable instruction by residents (33/49) and challenge to providing feedback on teaching (20/49). Resident teachers identified benefits including strengthening residency community, improved EM knowledge, and greater teaching skills. For nearly all resident participants, FoEM RaT impacted their career goals by affirming their interest in teaching. Conclusions The FoEM curricular model appears to be a valuable and feasible method to incorporate a RaT experience into EM residency training programs.
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Affiliation(s)
- Jaime Jordan
- Department of Emergency MedicineDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Amanda Amen
- Department of Emergency MedicineDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Anh Khoa Do
- UCLA School of Education and Information StudiesLos AngelesCaliforniaUSA
| | - Anwar Osborne
- Department of Emergency MedicineEmory UniversityAtlantaGeorgiaUSA
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Nishikura N, Ohta R, Sano C. Implementation of Near-Peer Learning for the Sustainability of Rural Family Medicine Education. Cureus 2023; 15:e43709. [PMID: 37724209 PMCID: PMC10505483 DOI: 10.7759/cureus.43709] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 09/20/2023] Open
Abstract
Balancing educators and trainees in community-based medical education (CBME) is essential for practical education in family medicine and the quality of care. The number of educators and trainees can be flexible in rural family medicine education. Implementing near-peer learning (NPL), in which trainees learn from each other and enhance their clinical skills, is complementary to medical education in rural medical education, which lacks medical educators. The Department of Community Care at the Unnan City Hospital has experienced significant changes in staffing structure. The previous structure of two consultants and six senior residents was replaced by losing one consultant and adding three senior residents. Therefore, the balance between the numbers of educators and learners changed significantly. Traditional teamwork methods no longer ensure effective team communication and balance; currently, effective teamwork does not occur within a team. The increased burden on consultants could result in lower patient outcomes and decreased quality of education for students and residents, thereby affecting the nurturing of future generations. To overcome these difficulties, we implemented the NPL. The implementation was based on strengths, weaknesses, opportunities, and threats (SWOT) and stakeholder analyses. This technical report demonstrated that NPL in rural family medicine education benefits the quality of rural medical education.
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Affiliation(s)
| | | | - Chiaki Sano
- Community Medicine Management, Shimane University, Izumo, JPN
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McKinney CM, Hart R, Patterson AC. Beyond Residents-as-Teachers: The Development of an Advanced Medical Education Pilot Elective for Pediatric Residents. Cureus 2023; 15:e40937. [PMID: 37496547 PMCID: PMC10368305 DOI: 10.7759/cureus.40937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction An advanced medical education elective can encompass themes that transcend traditional residents-as-teachers curricula. The literature is scarce regarding the development of such a curriculum for pediatric residents. Objectives To develop and implement an advanced medical education elective for pediatric residents and evaluate the effectiveness of the educational strategies and curriculum. Methods Kern's Six Steps were applied to create a two-week-long elective for pediatric residents. Residents worked through Kern's model to collaboratively develop the elective. Faculty were recruited based on expertise and content previously created. Residents developed teaching sessions for fourth-year medical students and received feedback. The curriculum was evaluated using quantitative and qualitative feedback with a five-point Likert scale and open-ended questions, group discussions, elective evaluations, and the New World Kirkpatrick Model. Results Five residents, 17 students, and 22 faculty participated. Lectures, expert panels, group discussions, and teaching sessions were seen as effective instructional methods. All residents were satisfied with the elective and its strategies and developed useful skills. Resident-led teaching sessions and interactive learning strategies were cited as a strength, while some redundancy was noted as a weakness. Faculty recommended more formal feedback on resident-led teaching sessions in the future. Conclusions Our medical education elective was designed collaboratively with residents on a medical education track. Strong faculty participation, asynchronous learning, and resident-led teaching sessions were strengths of the curriculum. The curriculum's reproducible components may serve as a foundation for institutions interested in improving their medical education didactics for residents. More research is needed to determine the external validity of this novel curriculum.
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Affiliation(s)
| | - Rebecca Hart
- Pediatric Emergency Medicine, University of Louisville School of Medicine, Louisville, USA
| | - Adam C Patterson
- Pediatric Emergency Medicine, University of Louisville School of Medicine, Louisville, USA
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Alwazzan L, AlHarithy R, Alotaibi HM, Kattan T, Alnasser M, AlNojaidi T. Dermatology residents as educators: a qualitative study of identity formation. BMC MEDICAL EDUCATION 2023; 23:199. [PMID: 36998009 PMCID: PMC10061385 DOI: 10.1186/s12909-023-04186-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND One of the many identities a physician comes to form during their career is their identity as an educator. Exploring formation of this identity may enrich our understanding of how physicians make decisions related to their roles as educators, their behaviors, and how this ultimately influences the educational environment. It is the aim of this study to investigate educator identity formation of dermatology residents while early in their careers. METHODS Drawing on a social constructionist paradigm, we conducted a qualitative study, utilizing an interpretative approach. We examined longitudinal data over a 12-month period using dermatology residents' written reflections from their professional portfolios and semi-structured interviews. We collected this data as we progressed through and beyond a 4-month professional development program designed to encourage residents' growth as educators. Sixty residents in their second, third, or final year of residency programs located in Riyadh, Saudi Arabia were invited to take part in this study. Twenty residents participated with sixty written reflections and 20 semi-structured interviews. Qualitative data were analyzed using a thematic analysis approach. RESULTS Sixty written reflections and 20 semi-structured interviews were analyzed. Data was categorized according to themes corresponding to the original research questions. For the first research question regarding identity formation, themes included definitions of education, the process of education, and identity development. For the second research question, 1 theme entitled professional development program included, the following sub-themes: individual act, interpersonal activity, and an organizational undertaking, with many believing that residency programs should prepare residents for their educator roles. Participants also described newfound leadership ambitions of creating new dermatology fellowship programs as a result of taking part in the Resident-as-Educator program. CONCLUSIONS Our study provides insights on the dynamic formation of educator identities amongst dermatology residents. Investment in developing residents as educators through professional development programs may instigate transformational change on the individual physician level and profession's level.
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Affiliation(s)
- Lulu Alwazzan
- Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia.
| | - Ruaa AlHarithy
- Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Thuraya Kattan
- Saudi Commission For Health Specialties, Riyadh, Saudi Arabia
| | | | - Taif AlNojaidi
- Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
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Ramani S, Thampy H, Grundy J, Sternschein R. Fostering clinical trainees' teacher identity. CLINICAL TEACHER 2022; 19:276-281. [PMID: 35734883 DOI: 10.1111/tct.13511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 06/13/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Subha Ramani
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.,Massachusetts General Hospital Institute for Health Professions Education, Boston, Massachusetts, USA
| | - Harish Thampy
- Faculty of Biology, Medicine and Health at the University of Manchester, Manchester, UK
| | - Jess Grundy
- Faculty of Biology, Medicine and Health at the University of Manchester, Manchester, UK
| | - Rebecca Sternschein
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Solomou G, Venkatesh A, Patel W, Chari A, Mohan M, Bandyopadhyay S, Gillespie CS, Mendoza N, Watts C, Jenkins A. A career in neurosurgery: perceptions and the impact of a national SBNS/NANSIG neurosurgery careers day. Br J Neurosurg 2022; 36:620-626. [PMID: 35603975 DOI: 10.1080/02688697.2022.2076807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Entrance to neurosurgical training is highly competitive. Without proper advice, information and opportunities, talented individuals may be dissuaded from applying. The Neurology and Neurosurgery Interest Group (NANSIG) organises a Careers Day in Neurosurgery every year. Our objective was to assess the overall utility of a neurosurgery careers day and the perceived factors that attract and detract from the specialty, from attendees of the ninth annual neurosurgery careers day. METHODS Eighteen-item pre-conference and 19-item post-conference questionnaires were disseminated electronically to conference attendees. Questions aimed to capture: (i) baseline demographics; (ii) previous experience and exposure in neurosurgery; (iii) interest in neurosurgery; (iv) understanding training and a career in neurosurgery; (v) perceived factors of attraction and dissuasion of neurosurgery; and (vi) perceived value, quality and educational purpose of the conference. RESULTS In total, 77 delegates attended the careers day. Most did not have a formal neurosurgical rotation during medical school (24.7%, n = 19), but almost half had gained neurosurgical experience and presented research work. The careers day increased knowledge of the neurosurgical application process (median Likert score 3/5 to 4/5, p < 0.01), duration of training (72.7-88.3%), and desire to pursue a career in neurosurgery (75.3-81.8%). The most commonly reported factors attracting delegates to neurosurgery were interest in neuroanatomy (80.5%, n = 62), practical skills (64.9%, n = 50), and impact on patients (62.3%, n = 48). The most common dissuasive factors were competition to entry (64.9%, n = 50), long working hours (40.3%, n = 31), and other career interests (35.1%, n = 27). Almost all would recommend the event to a colleague (94.9%, n = 73). CONCLUSIONS Formal undergraduate exposure to neurosurgery is limited. Neurosurgery careers days increase awareness and understanding of the application process and improve interest in a selected cohort. The factors attracting applicants to neurosurgery remain practical links to neuroanatomy, opportunities in neurosurgery for innovation and research, and direct impact on patients.
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Affiliation(s)
- Georgios Solomou
- Institute of Cancer and Genome Sciences, University of Birmingham, Birmingham, UK.,School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Ashwin Venkatesh
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Waqqas Patel
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Aswin Chari
- Great Ormond Street Institute of Child Health, University College London, London, UK.,Department of Neurosurgery, Great Ormond Street Hospital, London, UK
| | - Midhun Mohan
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Soham Bandyopadhyay
- Oxford University Global Surgery Group, Medical Sciences Division, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Conor S Gillespie
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Nigel Mendoza
- West London Neurosciences Unit, Charing Cross Hospital NHS Trust, London, UK
| | - Colin Watts
- Institute of Cancer and Genome Sciences, University of Birmingham, Birmingham, UK
| | - Alistair Jenkins
- Department of Neurosurgery, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
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Biesalski AS, Tönges L, von Kirchbauer I, Gülke E, Eisenberg H, Ippen FM, Schmidt-Graf F. Residents as teachers in Neurology: a Germany-wide survey on the involvement of neurological residents in clinical teaching. Neurol Res Pract 2022; 4:17. [PMID: 35527309 PMCID: PMC9080961 DOI: 10.1186/s42466-022-00170-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/03/2022] [Indexed: 11/28/2022] Open
Abstract
Background Residents play an important role in the clinical training of medical students, spending up to 25% of their daily work teaching. In the US medical curriculum didactic courses for residents already exist and their role as a teacher is firmly anchored. In Germany, there are no fixed regulations or residents-as-teachers-programs. The aim of this study was to evaluate the activities of neurological residents in clinical teaching.
Methods We conducted a prospective cross-sectional online survey among neurological residents in Germany. The evaluation was carried out descriptively and by means of text analysis. Results 138 residents from 39 German neurological university hospitals answered the survey. Nearly half of them needed the teaching activity as part of their career planning. The residents are mostly involved in practical courses. More than 80% stated, that they enjoy teaching. 64% stated that there were no preparatory courses for teaching at their hospital/university. 78.4% of the respondents received no or merely insufficient feedback for their own teaching and 62.5% had only little or even no knowledge about the university curriculum. Conclusions By teaching medical students, residents play an outstanding role in recruiting students for neurology and, simultaneously, teaching leads an improvement in the residents’ own learning. To encourage young neurologists as teachers and—at the same time as learners—Clinic directors and universities should promote residents-as-teachers programs in neurology and reward the residents’ teaching activities. Supplementary Information The online version contains supplementary material available at 10.1186/s42466-022-00170-3.
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Affiliation(s)
- Anne-Sophie Biesalski
- Department of Neurology, Ruhr-University Bochum, St. Josef Hospital, Gudrunstraße 56, 44791, Bochum, Germany.
| | - Lars Tönges
- Department of Neurology, Ruhr-University Bochum, St. Josef Hospital, Gudrunstraße 56, 44791, Bochum, Germany.,Center for Protein Diagnostics (ProDi), Ruhr University Bochum, Bochum, Germany
| | | | - Eileen Gülke
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hanna Eisenberg
- Department of Neurology, Universität Medical Center Göttingen, Göttingen, Germany
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Vlachou F, Zhang Y, Lee S, Mavroveli S, Patel B, Francis N. The development and evaluation of "Training the trainer" curriculum for surgical residents: Feasibility study. Int J Surg 2022; 98:106209. [PMID: 35007774 DOI: 10.1016/j.ijsu.2021.106209] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/13/2021] [Accepted: 12/22/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Over the last decades, there has been greater emphasis on enhancing teaching skills and concepts of Train-The-Trainer (TTT) have been widely adopted across surgical training programs. Current TTT curricula, however, mostly address teaching generic principles without specific guidance on how to teach technical skills among residents. The aim of this proof-of-concept study was to design a bespoke TTT curriculum for surgical technical skills and evaluate its impact. MATERIAL AND METHODS A bespoke TTT curriculum was developed to address key teaching surgical skills including a training framework, and performance enhancing feedback. The curriculum was delivered to 41 junior surgical residents in this feasibility study and focused on promoting a training framework including three domains; "set" involving pre-operative preparation, "dialogue" referring to teaching techniques and "closure" covering structured feedback. It was evaluated using Kirkpatrick's model: (i) course feedback; (ii) training quality assessment on a suturing simulated scenario using (a) Competency Assessment Tool (CAT) and a (b) Structured Training Trainer Assessment Report (STTAR) tool; (iii-iv) follow-up survey after one year. RESULTS The TTT curriculum was well-perceived, with a median score of 4/5 ("agree") across all components of evaluation forms. The simulated training scenario demonstrated a significant reduction in suturing errors following delivery of training (pre-TTT [4.25; IQR:4.42]; post-TTT [2.34; IQR:2.38], p-value = 0.014). Improvement in teaching was also noted and reflected in 'Set' (pre-TTT [3.50; IQR: 3.00] and post-TTT [5.00; IQR: 0.00], p-value = 0.019) and 'Closure' (pre-TTT [4.75; IQR: 1.88] and post-TTT [5.00; IQR: 0.00], p value = 0.007). 25% of participants contributed to the long-term survey highlighting that most practiced skills within 6 months of the curriculum with positive feedback from their learners. CONCLUSION This proof-of-concept study confirms the feasibility and acceptability of delivering a bespoke Train-The-Trainer curriculum to surgical residents. It provides a structured training framework that can enhance teaching technical skills.
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Affiliation(s)
- Florentia Vlachou
- Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London, EC1M 6AS, UK Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Garrod Building, Turner St, Whitechapel, London, E1 2AD, UK Princess Royal University Hospital, Farnborough Common, Orpington, BR6 8ND, United Kingdom St George's University Hospitals NHS Foundation Trust, Blackshaw Rd, London, SW17 0QT, United Kingdom Faculty of Medicine, Imperial Collage London St. Mary's Hospital, Paterson Centre, South Wharf Road, Paddington, London, W2 1BL, UK Department of Upper GI & Laparoscopic Surgery, Royal London Hospital, Whitechapel Rd, Whitechapel, London, E1 1FR, UK Department of Upper GI & Laparoscopic Surgery, University College London, 235 Euston Rd, Bloomsbury, London, NW1 2BU, UK Department of Colorectal Surgery, Yeovil District Hospital Foundation Trust, Yeovil, BA21 4AT, Somerset, UK The Griffin Institute, Northwick Park and St Mark's Hospital, Y Block, Watford Rd, Harrow, HA1 3UJ, UK Division of Surgery and Interventional Science, University College London, UK
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Effect of Residents-as-Teachers in Rural Community-Based Medical Education on the Learning of Medical Students and Residents: A Thematic Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312410. [PMID: 34886136 PMCID: PMC8656610 DOI: 10.3390/ijerph182312410] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/16/2022]
Abstract
Residents-as-teachers (RaT) is a theoretical framework emphasizing the significance of the similar learning background of teachers and learners. In Japan, community-based medical education (CBME) is a practical approach to teaching family medicine. This study aimed to investigate the impact and challenges of RaT on the learning of medical students and residents in CBME at a rural community hospital in Japan. Over the course of a year, the researchers conducted one-on-one interviews with three residents and ten medical students participating in family medicine training at the hospital. The interviews were recorded and transcribed verbatim. Grounded theory was used in the data analysis to clarify the findings. Three key themes emerged from the research: lack of educational experience with RaT, effectiveness of RaT, and challenges of RaT. Although participants were prejudiced against RaT, they felt its implementation could facilitate the establishment of beneficial relationships between learners and teachers. They were also able to participate in medical teams effectively. The findings suggest that the increased participation of senior doctors in RaT could strengthen its learning effects. RaT in rural CBME should be applied in various contexts, and its effectiveness should be further investigated both qualitatively and quantitatively.
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Møller JE, Kjaer LB, Helledie E, Nielsen LF, Malling BV. Transfer of communication teaching skills from university to the clinical workplace - does it happen? A mixed methods study. BMC MEDICAL EDUCATION 2021; 21:433. [PMID: 34404388 PMCID: PMC8369612 DOI: 10.1186/s12909-021-02834-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 07/15/2021] [Indexed: 05/30/2023]
Abstract
BACKGROUND Communication skills learned in the classroom do not transfer easily into clinical practice because they are not reinforced by teachers in the workplace setting and because lack of faculty training restricts the transfer of communication skills in real patient encounters. Trained university-based communication skills teachers often work simultaneously as doctors in clinics. This study explored if and how the skills of these teachers play a role in communication skills training in the clinical workplace. METHODS We used an exploratory sequential design: a mixed method approach that combined a survey with communication skills teachers, and qualitative individual interviews with these teachers and their educational leaders in clinical departments. The questionnaire was analysed using descriptive statistics. The interviews were analysed using content analysis. RESULTS The response rate was 34 %. A majority (93 %) used their communication skills when communicating with patients and relatives. Less than half taught communication in clinical departments. Approximately half of the respondents stated that encouragement from their leaders or colleagues would inspire them to use their teaching skills in the workplace. However, only 20 % had told their leaders about their competencies in teaching communication. One third thought that they needed further teacher training to teach in the clinical workplace. Qualitative analysis showed that teaching opportunities existed but mainly consisted of random, one-off sessions that came about through the initiative of the communication skills teachers themselves. The teachers described several barriers, such as the challenge of teaching colleagues, as communication relates to identity and hierarchical structures, as well as a lack of requests from colleagues or management, and department culture prioritizing topics relating to medical expertise. None of the educational leaders made use of the teachers' specific communication skills in a structured way: some saw it as unimportant, while others saw it as a potential resource. CONCLUSION Transfer of the teaching skills of communication skills teachers trained for university-based clinical communication training happened, but to a limited degree. Although both opportunities and barriers for transferring communication skills existed, barriers seemed to dominate, and opportunities for communication skills training in the workplace setting were not used to their full potential.
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Affiliation(s)
- Jane Ege Møller
- Department of Clinical Medicine, Aarhus University, INCUBA Skejby, Palle Juul- Jensens Boulevard 82, 8200 Aarhus N, Denmark
| | - Louise Binow Kjaer
- Centre for Health Sciences Education, Aarhus University, INCUBA Skejby, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark
| | - Emma Helledie
- Palliative Care Unit, Department of Oncology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Lone Folmer Nielsen
- Department of Clinical Medicine, Aarhus University, INCUBA Skejby, Palle Juul- Jensens Boulevard 82, 8200 Aarhus N, Denmark
| | - Bente Vigh Malling
- Department of Clinical Medicine, Aarhus University, INCUBA Skejby, Palle Juul- Jensens Boulevard 82, 8200 Aarhus N, Denmark
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Hayden C, Raidan J, Rees J, Oswal A. Understanding junior doctors' experiences of teaching on the acute take: a qualitative study. BMC MEDICAL EDUCATION 2021; 21:383. [PMID: 34256755 PMCID: PMC8278645 DOI: 10.1186/s12909-021-02815-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 07/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND New medical graduates are significantly unprepared to manage acutely unwell patients due to limited first-hand clinical exposure in the undergraduate curriculum. Supporting undergraduate learning in the acute setting can be challenging for junior doctors when balancing teaching and clinical responsibilities. Our aim was to explore junior doctors' first-hand experiences of supporting undergraduate education in the acute admissions environment(take). METHODS Fourteen junior doctors in one teaching hospital in South West England took part in semi-structured focus groups (4-6 participants in each) which were audio-recorded, transcribed, and thematically analysed. RESULTS Junior doctors described their educational role as comprising: teaching, demonstrating, coaching, and supervising. They perceived the acute take as a highly variable, unpredictable setting that offered a broad scope for learning. Tensions between doctors' clinical and educational roles were described, influenced by internal and external factors. Clinical work was prioritised over teaching and participants lacked confidence in supervisory and clinical skills. Doctors felt pressured to meet students' expectations and lacked understanding of their educational needs. Senior colleagues were highly influential in establishing an educational culture and were often a source of pressure to deliver timely clinical care. Organisations were perceived not to value teaching due to the lack of provision of dedicated teaching time and prioritisation of limited resources towards patient care. Participants managed tensions by attempting to formally separate roles, demoting students to passive observers, and they sought greater continuity in placements to better understand students' abilities and expectations. CONCLUSIONS Educational opportunities for undergraduate students on the acute take are varied and highly valuable. This study provides insight into the provision of workplace education and its challenges from junior doctors' perspectives. We highlight areas for improvement of relevance to educational providers.
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Affiliation(s)
- Charlotte Hayden
- Bristol Royal Infirmary, South Bristol Academy, University Hospitals of Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, BS2 8HW, Bristol, UK.
| | - Jedd Raidan
- Bristol Royal Infirmary, South Bristol Academy, University Hospitals of Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, BS2 8HW, Bristol, UK
- University of Bristol Medical School, 5 Tyndall Avenue, BS8 1UD, Bristol, UK
| | - Jonathan Rees
- Bristol Royal Infirmary, South Bristol Academy, University Hospitals of Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, BS2 8HW, Bristol, UK
| | - Abhishek Oswal
- Bristol Royal Infirmary, South Bristol Academy, University Hospitals of Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, BS2 8HW, Bristol, UK
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Ni L, Thomas HR, Raleigh DR, Boreta LC, Park CC, Braunstein SE. Residents-as-Teachers Curriculum for Radiation Oncology: A Targeted Needs Assessment. Int J Radiat Oncol Biol Phys 2021; 111:638-642. [PMID: 34153380 DOI: 10.1016/j.ijrobp.2021.06.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/02/2021] [Accepted: 06/11/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Achieving competency as educators is increasingly recognized as a critical part of residents' training in graduate medical education across specialties. In addition to teaching medical students, radiation oncology residents often play a vital role in peer and interprofessional education. We conducted a survey to identify the needs of radiation oncology residents for developing skills in teaching. METHODS AND MATERIALS An anonymous, web-based survey was developed and distributed to resident physicians at US radiation oncology programs. Analyses describe respondent demographics, experiences with teaching, and interest in various aspects of a formal "residents-as-teachers" curriculum. RESULTS There were 171 completed survey responses (27.5% response rate). A total of 146 residents (85.4%) reported receiving no formal training in teaching before residency, and 121 (70.8%) reported no formal training during residency. Residents who had formal training in teaching were significantly more likely to be "quite" or "extremely" confident about teaching compared with residents who had no prior formal training (76.0% vs 51.4%; P = .022). Residents most commonly taught other residents and medical students (163 [95.3%] and 160 [93.6%] respondents, respectively). The most common settings for teaching were one-on-one teaching (164 respondents [95.9%]), small-group lectures (135 respondents [78.9%]), and intradepartmental lectures (136 respondents [79.5%]). In response to open-ended questions regarding desired teaching opportunities and domains for teaching development, many residents expressed a lack of confidence in teaching and were interested in improvement across many aspects of teaching. CONCLUSIONS Radiation oncology residents are expected and desire to teach in a multitude of settings across a wide variety of audiences. However, a significant proportion of radiation oncology residents lack formal training and rarely receive feedback for their teaching skills. The results of this national survey support the development of a residents-as-teachers curriculum for radiation oncology residents that would address the needs for and significant interest in this area.
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Affiliation(s)
- Lisa Ni
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California.
| | - Horatio R Thomas
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - David R Raleigh
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - Lauren C Boreta
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - Catherine C Park
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - Steve E Braunstein
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
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Zaed I, Menna G, Tinterri B. Letter to the Editor: "Residents as Teachers in a Neurosurgical Setting: A Perspective". World Neurosurg 2021; 145:517-518. [PMID: 33348496 DOI: 10.1016/j.wneu.2020.10.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Ismail Zaed
- Department of Neurosurgery, Humanitas Clinical and Research Center-IRCCS, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
| | - Grazia Menna
- Institute of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Rome, Rome, Italy
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Rajan M, Middleton R, Field A, Pineda C, Kiffin N, Rosenthal A. Effectiveness of surgical residents compared to surgical faculty in teaching trauma evaluation and management. TRAUMA-ENGLAND 2021. [DOI: 10.1177/14604086211012245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Senior medical students learn trauma principles in a 90-min interactive teaching session based on the trauma evaluation and management module designed by the American College of Surgeons. However, the number of surgical faculty available to conduct these interactive small group sessions is limited. The goal of this study is to compare the effectiveness of surgical residents to that of surgical faculty in teaching trauma principles. Methods 53 senior medical students received trauma teaching from trauma faculty ( n = 22), trauma residents ( n = 21), or no teaching ( n = 10). Students were tested on cognitive trauma knowledge (20 multiple choice questions) and clinical trauma simulation (using objective structured clinical performance score). All students completed a 5-point subjective questionnaire. Results Students receiving trauma teaching outperformed students receiving no teaching in the knowledge test (mean 13.0 ± 3.6 standard deviation (SD) vs. 8.4 ± 2.4 SD, p < 0.05), while faculty and resident teaching outcomes were similar (mean 12.6 ± 3.0 SD vs. 13.4 ± 4.1, p = 0.45). Similarly, in the clinical trauma simulation, students receiving trauma teaching scored better (objective score mean 78% vs. 56%, p < 0.05), while there was no difference between faculty and resident teaching outcomes (objective score mean 77% vs. 80%, p = 0.52). In the subjective questionnaire, students who received trauma teaching rated themselves higher on a scale of 10 in trauma knowledge and skills than those who did not have formal teaching (mean 5.2 vs. 2.1, p < 0.05) as resident and attending teaching group ratings were similar. Conclusions Although small group discussions and increased simulation enhance undergraduate surgical trauma education, the number of faculty surgeons needed to fully incorporate these activities is limited. Objective and perceived effectiveness of teaching trauma management by surgical residents compared to trauma attendings is equivalent. This highlights the opportunity to incorporate residents into teaching roles to bridge the gap in undergraduate trauma education.
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Affiliation(s)
| | - Ravyn Middleton
- University of Texas Health Sciences Center at San Antonio, TX, USA
| | - Alyssa Field
- University of Texas Health Sciences Center at San Antonio, TX, USA
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Moerdler S, Costich M, Redwood EA, Catallozzi M, Friedman S. Boots on the Ground, Both Hands on the Keyboard: Harnessing the Power of Resident as Teacher Hybrid Teaching Skills in the Midst of the COVID-19 Pandemic. MEDICAL SCIENCE EDUCATOR 2021; 31:873-875. [PMID: 33495718 PMCID: PMC7815447 DOI: 10.1007/s40670-020-01185-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/03/2020] [Indexed: 06/12/2023]
Affiliation(s)
- Scott Moerdler
- Division of Pediatric Hematology Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, 195 Little Albany St, New Brunswick, NJ USA
| | - Marguerite Costich
- Department of Pediatrics, Columbia University Medical Center, New York, NY USA
| | - Emily Avis Redwood
- Department of Pediatrics, Columbia University Medical Center, New York, NY USA
| | - Marina Catallozzi
- Departments of Pediatrics and Population and Family Health, Columbia University Medical Center, NY New York, USA
| | - Suzanne Friedman
- Department of Pediatrics, Columbia University Medical Center, New York, NY USA
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Nothman S, Kaffman M, Nave R, Flugelman MY. Survey of faculty development in four Israeli medical schools: clinical faculty development is inadequate and clinical teaching is undervalued in Israeli faculties of medicine. Isr J Health Policy Res 2021; 10:10. [PMID: 33557931 PMCID: PMC7871531 DOI: 10.1186/s13584-021-00438-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 01/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Teaching medical students is a central part of being a doctor, and is essential for the training of the next generation of physicians and for maintaining the quality of medicine. Our research reviews the training that physicians in Israel receive as teachers of clinical clerkships, and their thoughts regarding teaching students. The importance of faculty development cannot be overstated, for securing quality medicine and physician empowerment. METHODS This study was based on a survey conducted among physicians teaching at Israeli medical schools. The survey was conducted using an online questionnaire sent to clinical teachers according to lists received from the teaching units of the faculties, department heads, and other clinical teachers. Participation in the study was anonymous. FINDINGS Of 433 invited physicians, 245 (56%) from three departments (internal medicine, paediatrics, obstetrics and gynaecology) of four faculties of medicine in Israel, out of five total, completed the questionnaire. Only 35% of the physicians reported having received training for their role as teachers, most of these participated in a short course of up to 2 days. There were significant differences between the Technion and the other schools. Technion teachers without academic appointment had higher rates of pedagogic training. The same was true in regard to Technion teachers, either residents or young specialist. Significant gaps were reported between the content covered in the training and the topics the doctors felt they would want to learn. The clinicians who participated in the survey expressed that clinical teaching was less valued and more poorly remunerated than research, and that improved compensation and perceived appreciation would likely improve the quality of clinical teaching. CONCLUSIONS Of the one-third of the physicians surveyed who had received some training in clinical teaching, the training was perceived as inadequate and not aligned with their needs. There was a significant difference in rates of pedagogic training between the Technion and other medical schools. In addition, most clinical teachers surveyed felt that teaching students is inadequately valued. Due to its focus on just three disciplines, and higher relative number participants from the Technion faculty of medicine, our survey may not fully represent the activities of the faculties of medicine in Israel. Nevertheless, given the importance of clinical teaching of medical students, our findings argue for increasing faculty development and educational training of physicians in clinical settings, for recognizing the importance of teaching in academic and professional promotion processes.
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Affiliation(s)
- Simon Nothman
- Department of Education, Ruth and Bruce Faculty of Medicine, Technion IIT, Haifa, Israel.,Department of Obstetrics and Gynaecology, Haemek Medical Center, Afula, Israel
| | - Michael Kaffman
- Department of Education, Ruth and Bruce Faculty of Medicine, Technion IIT, Haifa, Israel.,Department of Family Practice, Clalit Health Services, Haifa and Western Galilee District, Haifa, Israel
| | - Rachel Nave
- Department of Education, Ruth and Bruce Faculty of Medicine, Technion IIT, Haifa, Israel
| | - Moshe Y Flugelman
- Department of Education, Ruth and Bruce Faculty of Medicine, Technion IIT, Haifa, Israel. .,Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, 7 Michal St., Haifa, Israel.
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Bal C, Tesch ME, Blair G, Ostrow O, Premji L. Engaging medical trainees in resource stewardship through resident-led teaching sessions: a choosing wisely educational initiative. CANADIAN MEDICAL EDUCATION JOURNAL 2021; 12:e98-e100. [PMID: 33680239 PMCID: PMC7931484 DOI: 10.36834/cmej.70563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Implication Statement Overuse of healthcare resources is prevalent, including among medical trainees. As front-line clinicians and near-peers, residents are well-positioned to teach resource stewardship to medical students and address barriers students may face while trying to "choose wisely." We describe the implementation of two resident-led, case-based teaching sessions for medical students that focus on resource stewardship. Similar teaching models can be adapted by residents at their own institutions to enhance resource stewardship proficiency amongst trainees.
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Affiliation(s)
- Chandandeep Bal
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Megan E Tesch
- Department of Medical Oncology, British Columbia Cancer, British Columbia, Canada
| | - Geoffrey Blair
- Department of Surgery, Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Olivia Ostrow
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Ontario, Canada
- Division of Emergency Medicine, Department of Paediatrics, The Hospital for Sick Children, Ontario, Canada
| | - Laila Premji
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Ontario, Canada
- Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, Ontario, Canada
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Chaalan T, Landis Lewis D, O’Connor K, Popp B, Hammoud M, Mowers EL. Medical student and resident perceptions when working together in resident continuity clinics. MEDICAL EDUCATION ONLINE 2020; 25:1827532. [PMID: 33012265 PMCID: PMC7580839 DOI: 10.1080/10872981.2020.1827532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/17/2020] [Accepted: 09/19/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Resident continuity clinics (RCCs), where residents see patients largely independently, is a common requirement for residency programs in the USA. Students often participate in these clinics but it is unknown how this effects resident learning or student satisfaction. OBJECTIVE This study aims to describe effects on the learning environment when students and residents work together in an RCC. DESIGN Separate surveys were administered to residents and students working at St. Joseph Mercy Hospital (SJMH) in Ann Arbor, Michigan, from 2016-2018. RESULTS Response rates were 79/116 (68.1%) for students and 21/24 (87.5%) for residents. A one-sample Wilcoxon signed rank test was used to test whether most five-level Likert-type scale responses were 'agree' or 'strongly agree.' Of medical students, 88.6% enjoyed working with residents (p < 0.001) with 60.8% indicating residents were effective teachers (p < 0.001). The majority of residents (85.7%) were neutral, agreed, or strongly agreed that they enjoyed working with students (p < 0.001). However, 61.9% of residents believed they were too busy to be effective teachers (p < 0.001). CONCLUSIONS Both residents and students positively viewed their interactions in RCCs. Although most students felt residents were effective teachers, most residents worried about their ability to balance clinical care and teaching responsibilities.
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Affiliation(s)
- Tina Chaalan
- OB/GYN PGY-4 Resident, St. Joseph Mercy Hospital, Ann Arbor, MI, USA
| | - Deborah Landis Lewis
- Associate Residency Program Director OB/GYN, St. Joseph Mercy Hospital, Ann Arbor, MI, USA
| | - Kelly O’Connor
- Residency Program Director OB/GYN, St. Joseph Mercy Hospital, Ann Arbor, MI, USA
| | - Bryan Popp
- OB/GYN Department Chair, St. Joseph Mercy Hospital, Ann Arbor, MI, USA
| | - Maya Hammoud
- OB/GYN Medical Student Clerkship Director, Michigan Medicine, Ann Arbor, MI, USA
| | - Erika L Mowers
- OB/GYN Medical Student Clerkship Director, St. Joseph Mercy Hospital, Ann Arbor, MI, USA
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Dolan RS, Theriot D, Mendoza D, Ho C, Mullins ME, Peterson RB. Developing a Resident-led First-year Radiology Resident Lecture Series. Curr Probl Diagn Radiol 2020; 51:434-437. [PMID: 33221082 DOI: 10.1067/j.cpradiol.2020.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 10/16/2020] [Indexed: 11/22/2022]
Abstract
The first year of radiology residency presents many unique challenges, from transitioning into a completely new, specialized field to preparing for call. Implementation of a longitudinal lecture series dedicated towards the clinical demands of being a first-year radiology resident may improve their knowledge and comfort level, as well as benefit the entire program. In this article, we outline our experience with the development of a resident-led dedicated first-year radiology resident lecture series providing targeted, high-yield instruction on rotation logistics, basic physics and artifacts, examination protocolling, and common and "don't miss" pathology.
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Affiliation(s)
- Ryan S Dolan
- Emory University Department of Radiology, Emory University Hospital, Atlanta, GA.
| | - David Theriot
- Emory University Department of Radiology, Emory University Hospital, Atlanta, GA
| | | | - Christopher Ho
- Emory University Department of Radiology, Emory University Hospital, Atlanta, GA
| | - Mark E Mullins
- Emory University Department of Radiology, Emory University Hospital, Atlanta, GA
| | - Ryan B Peterson
- Emory University Department of Radiology, Emory University Hospital, Atlanta, GA
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Moyer KM, Ellman MS, Encandela J, Morrison LJ. Are Internal Medicine Residents Meeting the Bar? Comparing Resident Knowledge and Self-Efficacy to Published Palliative Care Competencies. Am J Hosp Palliat Care 2020; 38:326-331. [DOI: 10.1177/1049909120954807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background: There is a need for improved primary palliative care (PC) education and resident comfort with providing end-of-life care. Objective: Utilize a new instrument derived from published PC competencies to assess baseline Internal Medicine (IM) resident knowledge and self-efficacy in PC to identify educational gaps and create new PC curricula. Design: We created a 2-part instrument including a Knowledge Test (KT) and a Self-Efficacy Inventory (SEI) addressing 18 PC resident competencies across 5 domains: Pain and Symptom Management (PSM), Communication (COMM), Psychosocial, Spiritual, and Cultural Aspects of Care (PSC), Terminal Care and Bereavement (TCB), and Palliative Care Principles and Practice (PCPP). Setting/Subjects: The instrument was emailed to IM residents at our institution during academic years 2015-2016 and 2016-2017. Measurements: Basic descriptive statistics were performed for the KT and SEI. Mean Rank Analysis and One-way ANOVA were utilized for the KT and SEI, respectively. Congruence was calculated between knowledge and self-efficacy. Results: The mean score on the KT was 73% (range 33-80%). There was no significant difference in knowledge among post-graduate year cohorts. Self-efficacy scores were lower for interns overall and in PCPP, TCB, and COMM domains. Knowledge was concordant with self-efficacy in 42% of participants, higher than self-efficacy in 10% of participants, and lower than self-efficacy in 48% of participants. Conclusions: For approximately half of respondents, high self-efficacy in PC did not correlate with high PC knowledge. A more focused curriculum is needed to help IM residents facilitate mastery of PC competencies by graduation.
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Affiliation(s)
- Kristen M. Moyer
- Palliative Medicine Consultants, Hospice and Community Care, Lancaster, PA, USA
| | - Matthew S. Ellman
- Section of General Medicine, Department of Medicine, Yale School of Medicine, New Haven, CT, USA
| | - John Encandela
- Department of Psychiatry and Teaching and Learning Center, Yale School of Medicine, New Haven, CT, USA
| | - Laura J. Morrison
- Yale Palliative Care Program, Section of Geriatrics, Department of Medicine, Yale School of Medicine, New Haven, CT, USA
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Solomou G, Murphy S, Bandyopadhyay S, Horsfall HL, Mohan M, Chari A, Sinha S, Mendoza N. Neurosurgery specialty training in the UK: What you need to know to be shortlisted for an interview. Ann Med Surg (Lond) 2020; 57:287-290. [PMID: 32874557 PMCID: PMC7452085 DOI: 10.1016/j.amsu.2020.07.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/18/2020] [Accepted: 07/19/2020] [Indexed: 11/28/2022] Open
Abstract
Neurosurgery is one of the most competitive specialties in the UK. In 2019, securing an ST1 post in neurosurgery corresponds to competition ration of 6.54 whereas a CST1 post 2.93. Further, at ST3 level, neurosurgery is the most competitive. In addition, the number of neurosurgical training posts are likely to be reduced in the coming years. A number of very specific shortlisting criteria, aiming to filter and select the best candidates for interview exist. In the context of the high competition ratios and the specific shortlisting criteria, developing an interest in the neurosciences early on will allow individuals more time to meet the necessary standards for neurosurgery. Here, we aim to outline the shortlisting criteria and offer advice on how to achieve maximum scores, increasing the likelihood to be shortlisted for an interview. Neurosurgery is one of the most competitive specialities in the UK. At ST3 level neurosurgery is the most competitive surgical speciality in the UK. Leadership and management skills are desirable skills in the NHS.
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Affiliation(s)
| | - Suzanne Murphy
- Keele University Medical School, Stoke on Trent, UK.,UCD School of Medicine and Medical Science, Ireland
| | | | - Hugo Layard Horsfall
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Midhun Mohan
- Academic Division of Neurosurgery, Cambridge University Hospitals NHS Foundation Trust and University of Cambridge, UK
| | - Aswin Chari
- Department of Neurosurgery, Great Ormond Street Hospital, Institute of Child Health, University College London, UK
| | - Saurabh Sinha
- Sheffield Children's NHS Foundation Trust and Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - Nigel Mendoza
- West London Neurosciences Unit, Charing Cross Hospital NHS Trust, UK
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Bajwa NM, De Grasset J, Audétat MC, Jastrow N, Richard-Lepouriel H, Dominicé Dao M, Nendaz MR, Junod Perron N. Training junior faculty to become clinical teachers: The value of personalized coaching. MEDICAL TEACHER 2020; 42:663-672. [PMID: 32130055 DOI: 10.1080/0142159x.2020.1732316] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background: Junior clinical faculty require institutional support in the acquisition of feedback and clinical supervision skills of trainees. We tested the effectiveness of a personalized coaching versus guided self-reflection format of a faculty development program at improving faculty skills and self-efficacy.Methods: Participants were evaluated both before and after the program using a four-station Objective Structured Teaching Exercise (OSTE). A gain-score analysis, one-way ANOVA, and paired t-tests were used to evaluate both groups. The impact on the learning environment was measured by resident ratings of the Maastricht Clinical Teaching Questionnaire.Results: One hundred and twenty-seven participants completed the study over a three-year period. Both groups had significant improvements in self-efficacy. Participants in the coaching group demonstrated superior performance in encouraging learner self-reflection, teaching effectiveness, verifying learner understanding, exploring feelings/needs, and defining learning objectives. Over a 5-year period, the overall institutional learning climate significantly improved concerning faculty role-modeling, coaching, articulation, and explorations skills.Conclusion: Offering a contextualized faculty-development program using OSTEs that provides multiple opportunities for feedback and is focused on creating a community of practice is an effective method to facilitate the transfer of skills to the clinical environment, supports teacher identity development, and favorably impacts the learning climate.
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Affiliation(s)
- Nadia M Bajwa
- Department of General Pediatrics at the Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, Unit of Development and Research in Medical Education (UDREM), University of Geneva, Geneva, Switzerland
| | - Jehanne De Grasset
- Institute of Primary Care, Geneva University Hospitals, Geneva, Switzerland
| | - Marie-Claude Audétat
- Faculty of Medicine, Unit of Development and Research in Medical Education (UDREM), University of Geneva, Geneva, Switzerland
| | - Nicole Jastrow
- Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | | | - Melissa Dominicé Dao
- Division of Primary Care Medicine, Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Mathieu R Nendaz
- Faculty of Medicine, Unit of Development and Research in Medical Education (UDREM), University of Geneva, Geneva, Switzerland
| | - Noëlle Junod Perron
- Department of community medicine and primary care, Geneva University Hospitals, Geneva, Switzerland
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Dick ML, Henderson M, Wei Y, King D, Anderson K, Thistlethwaite J. A systematic review of the approaches to multi-level learning in the general practice context, using a realist synthesis approach: BEME Guide No. 55. MEDICAL TEACHER 2019; 41:862-876. [PMID: 31012386 DOI: 10.1080/0142159x.2019.1595554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background: Recent global increases in medical student numbers and shifts in medical education from teaching hospitals to community settings call for effective strategies to meet the demand for general practice teaching placements. It has been proposed that "multi-level learning" (MLL), in which learning and teaching are shared across different levels of learners, may provide teaching efficiencies and valuable experiences for learners and teachers. Aims: To identify, evaluate and synthesize the evidence related to the types, benefits, challenges, and facilitators of MLL in community-based general practice, and the underlying mechanisms and associated contexts to explain the reported outcomes. Method: A realist synthesis approach guided the systematic review. Results: Fifteen papers were identified, providing primary evaluation data predominantly from interviews with or surveys of key stakeholders. Generally, all levels of learners reported overall satisfaction with their MLL experiences. Medical students appreciated learning from prevocational doctors and registrars due to social and cognitive congruence. Mechanisms and contexts that supported our hypotheses regarding successful MLL outcomes were identified, with "a strong teaching culture" being a major mechanism. Conclusions: The findings can help inform practices considering the implementation or enhancement of MLL initiatives in general practice. Further research should include measuring defined learning outcomes.
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Affiliation(s)
- Marie-Louise Dick
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland , Brisbane , Australia
| | - Margaret Henderson
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland , Brisbane , Australia
| | - Yi Wei
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland , Brisbane , Australia
| | - David King
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland , Brisbane , Australia
| | - Katrina Anderson
- Academic Unit of General Practice, Australian National University Medical School , Canberra , Australia
| | - Jill Thistlethwaite
- Faculty of Arts and Social Sciences, University of Technology Sydney , Australia
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Deutsch T, Winter M, Lippmann S, Geier AK, Braun K, Frese T. Willingness, concerns, incentives and acceptable remuneration regarding an involvement in teaching undergraduates - a cross-sectional questionnaire survey among German GPs. BMC MEDICAL EDUCATION 2019; 19:33. [PMID: 30683085 PMCID: PMC6347773 DOI: 10.1186/s12909-018-1445-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 12/28/2018] [Indexed: 05/15/2023]
Abstract
BACKGROUND Worldwide, many undergraduate general practice curricula include community-based courses at general practitioners' (GPs') offices. Usually the academic general practice departments collaborate with networks of affiliated teaching practices. To successfully master the challenge of network development and extension, more information is needed about GPs' willingness to be involved in different teaching formats, important influencing factors, incentives, barriers, and the need for financial compensation. METHODS In this cross-sectional study a questionnaire survey was conducted among all GPs working in Leipzig and environs (German postal code area 04). In addition to descriptive statistics, group comparisons and logistic regression were performed to reveal differences between GPs with and without an interest in teaching. RESULTS Response rate was 45.3% with 339 analyzable questionnaires. The average age was 52.0 years and 58.4% were women. Sixty-two participants stated that they were already involved in teaching undergraduates. Altogether 60.1% of all GPs and 53.5% among those who didn't teach yet were basically interested in being involved in undergraduate education. The interested GPs could imagine devoting on average 6.9 h per month to teaching activities. GPs interested in teaching were on average younger, were more actively involved in continuing education and professional associations, and more frequently had pre-existing teaching experiences. The willingness to teach differed substantially among teaching formats. GPs were more willing to teach at their own practices rather than at university venues and they preferred skills-oriented content. Comprehensive organization on the part of the university including long-term scheduling and available teaching materials was rated as most important to increase the attractiveness of teaching. Time restraints and decreased productivity were rated as the most important barriers. Interested GPs appreciated financial compensation, particularly for teaching at university venues, and demanded amounts of money corresponding to German GPs' hourly income. CONCLUSIONS The GPs' interest in undergraduate teaching is generally high indicating a substantial pool of potential preceptors. Recruitment strategies should consider the collaboration with institutions involved in residency and continuing education as well as with professional associations. Comprehensive organization by the responsible department should be promoted and time restraints and decreased productivity should be overtly addressed and financially compensated.
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Affiliation(s)
- Tobias Deutsch
- Department of General Practice, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Marcus Winter
- Department of General Practice, Medical Faculty, University of Leipzig, Leipzig, Germany
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Stefan Lippmann
- Department of General Practice, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Anne-Kathrin Geier
- Department of General Practice, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Kristin Braun
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
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Fakhouri SA, Feijó LP, Augusto KL, Nunes MDPT. Teaching skills for medical residents: are these important? A narrative review of the literature. SAO PAULO MED J 2018; 136:571-578. [PMID: 30892488 PMCID: PMC9897134 DOI: 10.1590/1516-3180.2018.0147060818] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 08/06/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND There is extensive evidence, mainly from the United States and Canada, that points towards the need to train medical residents in teaching skills. Much of the "informal curriculum", including professional values, is taught by residents when consultants are not around. Furthermore, data from the 1960s show the importance of acquiring these skills, not only for residents but also for all doctors. -Teaching moments can be identified in simple daily situations, like discussing a clinical situation with patients and their families, planning patients' care with the healthcare team or teaching peers and medical students. The aim here was to examine the significance of resident teaching courses and estimate the effectiveness of these courses and the state of the art in Brazil. METHODS We conducted a review of the literature, using the MEDLINE, PubMed, SciELO and LILACS databases to extract relevant articles describing residents-as-teachers (RaT) programs and the importance of teaching skills for medical residents. This review formed part of the development of a doctoral project on medical education. RESULTS Original articles, reviews and systematic reviews were used to produce this paper as part of a doctoral project. CONCLUSIONS RaT programs are important in clinical practice and as role models for junior learners. -Moreover, these educational programs improve residents' self-assessed teaching behaviors and teaching confidence. On the other hand, RaT program curricula are limited by both the number of studies and their methodologies. In Brazil, there is no such experience, according to the data gathered here, except for one master's thesis.
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Affiliation(s)
| | - Lorena Pinho Feijó
- MD. Professional Master’s Student, Centro Universitário Christus (UNICHRISTUS), Fortaleza (CE), Brazil.
| | - Kristopherson Lustosa Augusto
- MD, PhD. Adjunct Professor, Department of Clinical Medicine, Faculdade de Medicina da Universidade Federal do Ceará (FAMED - UFC) and Universidade de Fortaleza (UNIFOR), Fortaleza (CE), Brazil.
| | - Maria do Patrocínio Tenório Nunes
- MD, PhD. Associate Professor, Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo (SP), Brazil.
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Watkins AA, Gondek SP, Lagisetty KH, Castillo-Angeles M, Gangadharan SP, Cahalane MJ, Kent TS. Weekly e-mailed teaching tips and reading material influence teaching among general surgery residents. Am J Surg 2017; 213:195-201.e3. [DOI: 10.1016/j.amjsurg.2016.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 03/19/2016] [Accepted: 05/05/2016] [Indexed: 10/21/2022]
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Mossanen M, Winters B, Lee F, Macleod LC, Haider M, Sutherland SE, Olsen R, Yang CC, Dalkin B, Choe J, Gore JL. Urinary Catheter Management for Nonurologists: A Resident Driven Educational Initiative. UROLOGY PRACTICE 2017; 4:85-90. [PMID: 37592588 DOI: 10.1016/j.urpr.2015.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Prevention of catheter associated urinary tract infection relies on timely catheter removal and care of indwelling catheters. Educational and quality improvement initiatives to prevent catheter associated urinary tract infection should address the basics of urinary catheter placement and management. Internal medicine residents are an appropriate target for these efforts and they may lack formal training in these issues. We developed a resident driven orientation session that covers basic Foley catheter management principles called the TIPS (Troubleshooting, Indications and Practice Sessions) program. METHODS Urology residents at our institution were queried on common consultations for urinary catheter related issues. The incoming intern internal medicine class at our institution completed a pre-TIPS survey that evaluated their baseline urological experience and knowledge. A 1-hour didactic session led by urology residents was followed by hands-on directed practice with mannequins. The web based survey was repeated 1 month later. RESULTS Of the total of 60 residents 54 (90%) completed the initial survey. In medical school 38 of 54 residents (70%) had never rotated in urology. Upon repeating the survey at 1 month the response rate was 34 of 60 residents (57%). The proportion of residents confident in their ability to troubleshoot catheter problems increased from 50% to 88% (p <0.05). Knowledge of indications, clot retention and proper catheter technique also improved (p <0.05). CONCLUSIONS A focused educational session about common urological catheter management scenarios resulted in improved internal medicine resident confidence in catheter troubleshooting and knowledge of basic urinary catheter placement indications. These educational sessions may be a method to improve nonurology resident education and awareness of common urological issues.
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Affiliation(s)
- Matthew Mossanen
- Department of Urology, University of Washington, Seattle, Washington
| | - Brian Winters
- Department of Urology, University of Washington, Seattle, Washington
| | - Franklin Lee
- Department of Urology, University of Washington, Seattle, Washington
| | - Liam C Macleod
- Department of Urology, University of Washington, Seattle, Washington
| | - Maahum Haider
- Department of Urology, University of Washington, Seattle, Washington
| | | | - Robin Olsen
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Claire C Yang
- Department of Urology, University of Washington, Seattle, Washington
| | - Bruce Dalkin
- Department of Urology, University of Washington, Seattle, Washington
| | - John Choe
- Department of Medicine, University of Washington, Seattle, Washington
| | - John L Gore
- Department of Urology, University of Washington, Seattle, Washington
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Teaching school children basic life support improves teaching and basic life support skills of medical students: A randomised, controlled trial. Resuscitation 2016; 108:1-7. [PMID: 27576085 DOI: 10.1016/j.resuscitation.2016.08.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 07/18/2016] [Accepted: 08/04/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND The "kids save lives" joint-statement highlights the effectiveness of training all school children worldwide in cardiopulmonary resuscitation (CPR) to improve survival after cardiac arrest. The personnel requirement to implement this statement is high. Until now, no randomised controlled trial investigated if medical students benefit from their engagement in the BLS-education of school children regarding their later roles as physicians. The objective of the present study is to evaluate if medical students improve their teaching behaviour and CPR-skills by teaching school children in basic life support. METHODS The study is a randomised, single blind, controlled trial carried out with medical students during their final year. In total, 80 participants were allocated alternately to either the intervention or the control group. The intervention group participated in a CPR-instructor-course consisting of a 4h-preparatory seminar and a teaching-session in BLS for school children. The primary endpoints were effectiveness of teaching in an objective teaching examination and pass-rates in a simulated BLS-scenario. RESULTS The 28 students who completed the CPR-instructor-course had significantly higher scores for effective teaching in five of eight dimensions and passed the BLS-assessment significantly more often than the 25 students of the control group (Odds Ratio (OR): 10.0; 95%-CI: 1.9-54.0; p=0.007). CONCLUSIONS Active teaching of BLS improves teaching behaviour and resuscitation skills of students. Teaching school children in BLS may prepare medical students for their future role as a clinical teacher and support the implementation of the "kids save lives" statement on training all school children worldwide in BLS at the same time.
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Goh SH, Tan JHM, Cook S. Student’s perspective of Residents as educators following introduction of Accreditation Council for Graduate Medical Education-International (ACGME-I) in SingHealth Residency. PROCEEDINGS OF SINGAPORE HEALTHCARE 2016. [DOI: 10.1177/2010105816641971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: Singapore’s postgraduate medical education underwent a transition in 2010, moving away from the House staff model to the American Residency model. Teaching was defined as a core competency for SingHealth Residency programs. This study sought to determine how this transition impacted medical students’ perception of Residents as teachers. Methods: A 19-item Likert-type questionnaire comprising three domains—(1) quality, (2) frequency and (3) engagement—was given to all Duke-NUS medical students at the end of each clerkship from the academic year (AY) 2009–10 through 2013–14. The first two academic years were classified as the pre-initiation stage of the Residency, and the latter three, the post-initiation stage. Students rated Residents they encountered in their most recent clerkship. Results: Student ratings have gradually improved, with the largest improvement occurring after the initiation of Residency, and after the introduction of Residents as Future Teachers courses. Student ratings in the post-initiation Residency years combined were significantly higher than the pre-initiation of Residency years combined, for all three domains. Analysis of individual items revealed significant improvement in student ratings on all items in all domains, except for the quality of teaching in performing procedural skills. Conclusion: Findings from this study indicate a positive shift in the teaching culture with the transition of Singapore’s postgraduate medical education from the House staff model to the Residency program.
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Affiliation(s)
- Sok Hong Goh
- Medical Education, Research and Evaluation Department, Duke-NUS Medical School
| | | | - Sandy Cook
- Medical Education, Research and Evaluation Department, Duke-NUS Medical School
- Academic Medicine Education Institute, Duke-NUS Medical School
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Ramani S, Mann K, Taylor D, Thampy H. Residents as teachers: Near peer learning in clinical work settings: AMEE Guide No. 106. MEDICAL TEACHER 2016; 38:642-55. [PMID: 27071739 DOI: 10.3109/0142159x.2016.1147540] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This AMEE Guide provides a framework to guide medical educators engaged in the design and implementation of "Resident as Teacher" programs. The suggested approaches are based on established models of program development: the Program Logic model to guide program design, the Dundee three-circle model to inform a systematic approach to planning educational content and the Kirkpatrick pyramid, which forms the backbone of program evaluation. The Guide provides an overview of Resident as Teacher curricula, their benefits and impact, from existing literature supplemented by insights from the authors' own experiences, all of whom are engaged in teaching initiatives at their own institutions. A conceptual description of the Program Logic model is provided, a model that highlights an outcomes-based curricular design. Examples of activities under each step of this model are described, which would allow educational leaders to structure their own program based on the scope, context, institutional needs and resources available. Emphasis is placed on a modular curricular format to not only enhance the teaching skills of residents, but also enable development of future career educators, scholars and leaders. Application of the Dundee three-circle model is illustrated to allow for a flexible curricular design that can cater to varying levels of educational needs and interests. In addition, practical advice is provided on robust assessment of outcomes, both assessment of participants and program evaluation. Finally, the authors highlight the need for congruence between the formal and hidden curriculum through explicit recognition of the value of teaching by institutions, support for development of teaching programs, encouragement of evidence-based approach to education and rewards for all levels of teachers.
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Affiliation(s)
- Subha Ramani
- a Department of Medicine , Brigham and Women's Hospital , Harvard Medical School, Boston , MA , USA
| | - Karen Mann
- b Division of Medical Education, Faculty of Medicine , Dalhousie University , Halifax , Nova Scotia , Canada
| | - David Taylor
- c School of Medicine , University of Liverpool , Liverpool , UK
| | - Harish Thampy
- d Manchester Medical School, University of Manchester , Manchester , UK
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Dotters-Katz S, Hargett CW, Zaas AK, Criscione-Schreiber LG. What motivates residents to teach? The Attitudes in Clinical Teaching study. MEDICAL EDUCATION 2016; 50:768-77. [PMID: 27295481 DOI: 10.1111/medu.13075] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 11/09/2015] [Accepted: 03/14/2016] [Indexed: 05/18/2023]
Abstract
CONTEXT Graduate medical trainees have a critical role in the teaching of other trainees. Improving their teaching requires an understanding of their attitudes towards teaching and their motivation to teach. Both have been incompletely explored in this population. We aimed to better understand graduate medical trainees' attitudes towards teaching and motivation to teach in the clinical setting in order to inform modifications to resident-as-teacher (RAT) programmes and enhance teaching practices. METHODS We applied Q methodology, an established sorting method, to identify and quantify the factors that have an impact on trainees' engagement in teaching. We invited house officers at our institution to rank-order 47 statements regarding their attitudes to and motivation for teaching. Respondents explained their Q-sort rankings in writing and completed a demographic questionnaire. By-person factor analysis yielded groups of individuals with similar attitudes. RESULTS One hundred and seven trainees completed the Q-sort. We found three primary groups of attitudes towards teaching in the clinical setting: enthusiasm, reluctance and rewarded. Enthusiastic teachers are committed and make time to teach. Teaching increases their job satisfaction. Reluctant teachers have enthusiasm but are earlier in training and feel limited by clinical workload and unprepared. Rewarded teachers feel teaching is worthwhile and derive satisfaction from the rewards and recognition they receive for teaching. CONCLUSIONS This improved understanding of common attitudes shared by groups of residents will help curriculum designers create RAT programmes to further reinforce and encourage attitudes that promote teaching as well as improve trainees' motivation to teach. Designing RAT programmes that acknowledge the attitudes to and motivations for teaching should help develop effective teachers to improve educational outcomes. Directed efforts to enhance motivation for reluctant teachers and encourage more positive attitudes in rewarded teachers may lead to improved teaching behaviours among residents.
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Affiliation(s)
- Sarah Dotters-Katz
- Division of Maternal Fetal Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Charles W Hargett
- Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Aimee K Zaas
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA
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A peer-designed selective in anesthesiology, critical care, and perioperative medicine for first- and second-year medical students. J Clin Anesth 2016; 31:175-81. [PMID: 27185704 DOI: 10.1016/j.jclinane.2016.02.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 01/27/2016] [Accepted: 02/12/2016] [Indexed: 11/24/2022]
Abstract
STUDY OBJECTIVE The objective of this study was to design and implement a preclinical elective (termed selective) in anesthesiology, critical care, and perioperative medicine and to report survey results assessing the impact of the selective on first- and second-year medical students' understanding of basic concepts, comfort with procedural skills, and interest in the specialty. DESIGN Preinvention and postintervention survey evaluation was used as the design of this study. SETTING The study was conducted at Mayo Medical School and Mayo Clinic. PARTICIPANTS The participants in this study are first- and second-year medical students. INTERVENTIONS A 1-week introductory anesthesiology curriculum was developed to include didactic sessions, shadowing experiences, lunch and dinner panels, mentorship and networking opportunities, and procedural workshops in airway management, ultrasound, and vascular access techniques. MEASUREMENTS Preselective and postselective surveys using a 10-point scale (1, strongly disagree; 10, strongly agree) were administered 1 week before and after the selective. MAIN RESULTS A total of 8 students participated in the selective, with a 100% survey response rate. Students reported significant increases for all survey questions regarding basic concepts and skills. The largest increases were reported in comfort with airway management skills, understanding of the perioperative surgical home model, and vascular access skills. All participants indicated a higher likelihood of pursuing anesthesiology as a career and attributed their increased interest in anesthesiology to the selective. CONCLUSIONS This new selective was successful in giving first- and second-year medical students a comprehensive overview of anesthesiology and increasing medical student interest in the specialty. The success of this selective leads to promising belief that similar peer-designed educational experiences can be developed at other medical schools to improve education and interest in this area of medicine.
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Dannaway J, Ng H, Schoo A. Literature review of teaching skills programs for junior medical officers. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2016; 7:25-31. [PMID: 26826798 PMCID: PMC4733566 DOI: 10.5116/ijme.5685.14da] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 12/31/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of this review was to assess the current evidence regarding the efficacy of teaching skills programs for junior medical officers. We aimed to compare and contrast these results with findings from previous literature reviews, the last of which were published in 2009. METHODS In order to capture studies since the last published literature reviews, five databases and grey literature were searched for publications from January 2008 to January 2015. A search for literature reviews without using the timeframe limitation was also performed. RESULTS The search from January 2008 to January 2015 resulted in the inclusion of 12 studies. Five systematic reviews of the topic were found which included 39 individual studies that were also analysed. Nearly all studies reported positive effects. Twenty nine studies reported change in attitudes, 28 reported modification in knowledge, 28 reported change in behaviour, 6 reported change in the organisation and two reported change in program participant's students. There were substantial threats of bias present. CONCLUSIONS The literature reviewed demonstrated many positive effects of teaching skills programs, which supports their utilization. However, high level outcomes need to be evaluated over longer periods of time to establish their true impact. An organisation specific approach to these programs needs to occur using sound course design principles, and they need to be reported in evaluation trials that are designed with robust methodology.
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Affiliation(s)
- Jasan Dannaway
- Flinders University, School of Medicine, Sturt Road, Bedford Park, Adelaide, South Australia, Australia
| | - Heryanto Ng
- Flinders University, School of Medicine, Sturt Road, Bedford Park, Adelaide, South Australia, Australia
| | - Adrian Schoo
- Flinders University, School of Medicine, Sturt Road, Bedford Park, Adelaide, South Australia, Australia
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Kalra R, Modi JN, Vyas R. Involving postgraduate's students in undergraduate small group teaching promotes active learning in both. Int J Appl Basic Med Res 2015; 5:S14-7. [PMID: 26380201 PMCID: PMC4552056 DOI: 10.4103/2229-516x.162256] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 06/20/2015] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Lecture is a common traditional method for teaching, but it may not stimulate higher order thinking and students may also be hesitant to express and interact. The postgraduate (PG) students are less involved with undergraduate (UG) teaching. Team based small group active learning method can contribute to better learning experience. AIM To-promote active learning skills among the UG students using small group teaching methods involving PG students as facilitators to impart hands-on supervised training in teaching and managerial skills. METHODOLOGY After Institutional approval under faculty supervision 92 UGs and 8 PGs participated in 6 small group sessions utilizing the jigsaw technique. Feedback was collected from both. OBSERVATIONS Undergraduate Feedback (Percentage of Students Agreed): Learning in small groups was a good experience as it helped in better understanding of the subject (72%), students explored multiple reading resources (79%), they were actively involved in self-learning (88%), students reported initial apprehension of performance (71%), identified their learning gaps (86%), team enhanced their learning process (71%), informal learning in place of lecture was a welcome change (86%), it improved their communication skills (82%), small group learning can be useful for future self-learning (75%). Postgraduate Feedback: Majority performed facilitation for first time, perceived their performance as good (75%), it was helpful in self-learning (100%), felt confident of managing students in small groups (100%), as facilitator they improved their teaching skills, found it more useful and better identified own learning gaps (87.5%). CONCLUSIONS Learning in small groups adopting team based approach involving both UGs and PGs promoted active learning in both and enhanced the teaching skills of the PGs.
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Affiliation(s)
- Ruchi Kalra
- Department of Obstetrics and Gynaecology, People's College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Jyoti Nath Modi
- Department of Obstetrics and Gynaecology, People's College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Rashmi Vyas
- Foundation for Advancement of International Medical Education and Research, Philadelphia, USA
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Gouda P, Fanous S, Gouda J, Boland J, Geoghegan R. Paediatric learning in a clinical attachment: undergraduate medical students' perspectives. Ir J Med Sci 2015; 185:413-21. [PMID: 25904344 DOI: 10.1007/s11845-015-1302-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 04/11/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND The clinical environment in paediatrics presents many unique challenges for medical students to achieve clinical proficiency. AIMS Our study aimed to explore how different elements of the paediatric rotation aid medical students in achieving learning outcomes at the undergraduate stage. METHODS Using a small-scale exploratory case study, three focus group interviews were conducted with 19 participants by an independent facilitator. Students' self-reported levels of achievement of module learning outcomes were also analysed. Qualitative data were recorded, transcribed and thematically analysed. Open coding was initially employed; codes were then refined into categories and grouped. Themes were identified, reviewed and defined. RESULTS Students highlighted several key themes including trainee factors, teacher factors and environmental factors that were associated with positive learning environments. These included the opportunity to contribute to the patient care, feeling like part of the team. CONCLUSIONS A clinical learning environment that allows medical students to become actively involved in patient care and to contribute as members to the clinical team can enhance their learning experience.
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Affiliation(s)
- P Gouda
- School of Medicine, National University of Ireland Galway, Clinical Science Institute, Newcastle Road, Galway, Co. Galway, Ireland.
| | - S Fanous
- School of Medicine, National University of Ireland Galway, Clinical Science Institute, Newcastle Road, Galway, Co. Galway, Ireland
| | - J Gouda
- School of Medicine, National University of Ireland Galway, Clinical Science Institute, Newcastle Road, Galway, Co. Galway, Ireland
| | - J Boland
- School of Medicine, National University of Ireland Galway, Clinical Science Institute, Newcastle Road, Galway, Co. Galway, Ireland
| | - R Geoghegan
- School of Medicine, National University of Ireland Galway, Clinical Science Institute, Newcastle Road, Galway, Co. Galway, Ireland
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de Villiers MR, Cilliers FJ, Coetzee F, Herman N, van Heusden M, von Pressentin KB. Equipping family physician trainees as teachers: a qualitative evaluation of a twelve-week module on teaching and learning. BMC MEDICAL EDUCATION 2014; 14:228. [PMID: 25335697 PMCID: PMC4287426 DOI: 10.1186/1472-6920-14-228] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 10/13/2014] [Indexed: 05/31/2023]
Abstract
BACKGROUND There is a dire need to expand the capacity of institutions in Africa to educate health care professionals. Family physicians, as skilled all-rounders at district level, are potentially well placed to contribute to an extended training platform in this context. To play this role, they need to both have an understanding of their specialist role that incorporates teaching and be equipped for their role as trainers of current and future health workers and specialists. A teaching and learning capacity-building module was introduced into a new master's programme in family medicine at Stellenbosch University, South Africa. We report on the influence of this module on graduates after the first six years. METHODS A qualitative study was undertaken, interviewing thirteen graduates of the programme. Thematic analysis of data was done by a team comprising tutors and graduates of the programme and an independent researcher. Ethical clearance was obtained. RESULTS The module influenced knowledge, skills and attitudes of respondents. Perceptions and evidence of changes in behaviour, changes in practice beyond the individual respondent and benefits to students and patients were apparent. Factors underlying these changes included the role of context and the role of personal factors. Contextual factors included clinical workload and opportunity pressure i.e., the pressure and responsibility to undertake teaching. Personal factors comprised self-confidence, modified attitudes and perceptions towards the roles of a family physician and towards learning and teaching, in addition to the acquisition of knowledge and skills in teaching and learning. The interaction between opportunity pressure and self-confidence influenced the application of what was learned about teaching. CONCLUSIONS A module on teaching and learning influenced graduates' perceptions of, and self-reported behaviour relating to, teaching as practicing family physicians. This has important implications for educating family physicians in and for Africa and indirectly on expanding capacity to educate health care professionals in Africa.
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Affiliation(s)
- Marietjie R de Villiers
- />Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Francois J Cilliers
- />Education Development Unit, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- />Centre for Health Professions Education, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Francois Coetzee
- />Ukwanda Rural Clinical School, Stellenbosch University, Stellenbosch, South Africa
| | - Nicoline Herman
- />Centre for Teaching and Learning, Stellenbosch University, Stellenbosch, South Africa
| | - Martie van Heusden
- />Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Klaus B von Pressentin
- />Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Almasri H, Moza A, Kayyali A, Khuder S, Assaly R. Resident perceptions regarding teaching medical students. MEDICAL TEACHER 2013; 35:422. [PMID: 23600669 DOI: 10.3109/0142159x.2012.737969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Coleman MM, Blatt B, Greenberg L. Preparing students to be academicians: a national student-led summer program in teaching, leadership, scholarship, and academic medical career-building. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2012; 87:1734-1741. [PMID: 23095923 DOI: 10.1097/acm.0b013e318271cfd6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Medical schools have the responsibility of producing future leaders in academic medicine, yet few students choose academic medicine as a career. In 2009, the American Medical Student Association (AMSA) and the George Washington University School of Medicine and Health Sciences joined forces to provide students with a comprehensive introduction to careers in academic medicine through the redesign of an existing annual summer program for medical students. Since 2004, AMSA had hosted the Medical Education Leadership Institute, a weeklong program that attracted medical students from across the country who were interested in gaining teaching skills. In the redesigned sixth annual program, the authors expanded the curriculum to include principles of leadership, of medical education scholarship (or project development), and of academic medicine career-building. The purpose of this article is to describe the features of this comprehensive program and to share the lessons learned from its development and implementation. The authors also describe the multifaceted approach they used to evaluate the program, which featured a rubric they derived from social cognitive career theory.
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Lelorain S, Sultan S, Zenasni F, Catu-Pinault A, Jaury P, Boujut E, Rigal L. Empathic concern and professional characteristics associated with clinical empathy in French general practitioners. Eur J Gen Pract 2012; 19:23-8. [PMID: 22908989 DOI: 10.3109/13814788.2012.709842] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Clinical empathy, i.e. the ability of physicians to adopt patient perspective, is an essential component of care, which depends in part on empathic concern, i.e. compassionate emotions felt for others. However, too much empathic concern can be challenging for physicians. Aim of this study was to examine physician practice characteristics that could explain clinical empathy beyond empathic concern. We were also interested in testing whether professional reflective activities, such as Balint group attendance or clinical supervision, might make clinical empathy less dependent on empathic concern. METHODS A total of 295 French general practitioners (response rate of 37%) completed self-reported questionnaires on empathic concern and clinical empathy, using the Toronto empathy questionnaire (TEQ) and the Jefferson scale of physician empathy (JSPE), respectively. We also recorded information on their professional practice: professional experience, duration of consultations, and participation in Balint groups or being a clinical supervisor. Hierarchical regression analyses were carried out with clinical empathy as dependent variable. RESULTS Empathic concern was an important component of clinical empathy variance. The physician practice characteristics 'consultation length' and 'being a Balint attendee or a supervisor,' but not 'clinical experience' made a significant and unique contribution to clinical empathy beyond that of empathic concern. Participating to one reflective activity (either Balint group attendance or clinical supervision) made clinical empathy less dependent on empathic concern. CONCLUSION Working conditions such as having enough consultation time and having the opportunity to attend a professional reflective activity support the maintenance of clinical empathy without the burden of too much empathic concern.
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O'Brien BC, Poncelet AN, Hansen L, Hirsh DA, Ogur B, Alexander EK, Krupat E, Hauer KE. Students' workplace learning in two clerkship models: a multi-site observational study. MEDICAL EDUCATION 2012; 46:613-24. [PMID: 22626053 DOI: 10.1111/j.1365-2923.2012.04271.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
CONTEXT Longitudinal integrated clerkships (LICs) are established, rapidly growing models of education designed to improve the core clinical year of medical school using guiding principles about workplace learning and continuity. This study is the first to report data from direct observations of workplace learning experiences of students on LICs and traditional block clerkships (BCs), respectively. METHODS This multi-institution study used an observational, work-sampling methodology to compare LIC and BC students early and late in the core clinical year. Trained research assistants documented students' activities, participation (observing, with assistance, alone), and interactions every 10 minutes over 4-hour periods. Each student was observed one to three times early and/or late in the year. Data were aggregated at the student level and by in-patient or out-patient setting for BC students. One-way analysis of variance (anova) was used to compare two groups early in the year (LIC and BC students) and three groups late in the year (LIC, out-patient BC and in-patient BC students). RESULTS Early-year observations included 26 students (16 LIC and 10 BC students); late-year observations included 44 students (28 LIC, eight out-patient BC and eight in-patient BC students). Out-patient activities and interactions of LIC and BC students were similar early in the year, but in the later period LIC students spent significantly more time performing direct patient care activities alone (25%) compared with out-patient (12%) and in-patient (7%) BC students. Students on LICs were significantly more likely to experience continuity with patients as 34% of their patients returned to them, whereas only 5% of patients did so for out-patient BC students late in the year. CONCLUSIONS By late year, LIC students engage in patient care more independently and have more opportunities to see clinic patients on multiple occasions than BC students. Consistent with the principles of workplace learning, these findings suggest that yearlong longitudinal integrated education models, that rely mostly on ambulatory settings, afford students greater opportunities to participate more fully in the provision of patient care.
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Affiliation(s)
- Bridget C O'Brien
- Department of Medicine, University of California San Francisco (UCSF), San Francisco, CA, USA.
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Snell L. The Resident-as-Teacher: It's More Than Just About Student Learning. J Grad Med Educ 2011; 3:440-1. [PMID: 22942984 PMCID: PMC3179240 DOI: 10.4300/jgme-d-11-00148.1] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 07/01/2011] [Indexed: 11/06/2022] Open
Affiliation(s)
- Linda Snell
- Corresponding author: Linda Snell, MD, MHPE, FRCPC, FACP, Centre for Medical Education, McGill University, 2nd floor, Lady Meredith House, 1110 Pine Avenue West, Montreal, Quebec, Canada, H3A 1A3. 514.398.8264,
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Le-Bucklin KVT, Hicks R, Wong A. Impact of a teaching rotation on residents' attitudes toward teaching: a 5-year study. J Grad Med Educ 2011; 3:253-5. [PMID: 22655153 PMCID: PMC3184907 DOI: 10.4300/jgme-d-10-00123.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Revised: 12/01/2010] [Accepted: 01/27/2011] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Residents play a tremendous role in educating medical students and other residents during their training. Many residency programs have thus instituted formal instruction on teaching. This 5-year study was conducted to quantitatively evaluate the impact of a teaching rotation on residents' attitudes towards teaching. METHODS Residents participated in a 1-month teaching rotation, which included didactic sessions as well as protected time to practice their teaching skills. Before and after the rotation, residents anonymously filled out surveys regarding their attitudes towards teaching. Data were collected from 73 residents from July 2004 to September 2009. The data were analyzed using a 2-tailed t-test with independent variables and a 1-way ANOVA followed by a posttest. RESULTS Four categories showed significant improvement, including feeling prepared to teach (P < .0001), having confidence in their teaching ability (P < .0001), being aware of their expectations as a teacher (P < .0001), and feeling that their anxiety about teaching was at a healthy level (P = .0037). There was an increase in the level of enthusiasm, but the P value did not reach a significant range (P = .12). The level of enthusiasm started high and was significantly higher on the pretest than every other tested category (P < .0001). Footnote c to Table 2 should read: P value as calculated using the Mann-Whitney U test [corrected]. CONCLUSIONS Residents are enthusiastic about teaching, and their level of enthusiasm remains high following a teaching rotation. Residents feel more prepared to teach, more confident in their teaching ability, more aware of their expectations as a teacher, and less anxious about teaching following a formal teaching rotation.
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Donovan A. Radiology resident teaching skills improvement: impact of a resident teacher training program. Acad Radiol 2011; 18:518-24. [PMID: 21377594 DOI: 10.1016/j.acra.2010.10.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2010] [Revised: 10/12/2010] [Accepted: 10/12/2010] [Indexed: 11/30/2022]
Abstract
RATIONALE AND OBJECTIVES Teaching is considered an essential competency for residents to achieve during their training. Instruction in teaching skills may assist radiology residents in becoming more effective teachers and increase their overall satisfaction with teaching. The purposes of this study were to survey radiology residents' teaching experiences during residency and to assess perceived benefits following participation in a teaching skills development course. MATERIALS AND METHODS Study participants were radiology residents with membership in the American Alliance of Academic Chief Residents in Radiology or the Siemens AUR Radiology Resident Academic Development Program who participated in a 1.5-hour workshop on teaching skills development at the 2010 Association of University Radiologists meeting. Participants completed a self-administered, precourse questionnaire that addressed their current teaching strategies, as well as the prevalence and structure of teaching skills training opportunities at their institutions. A second postcourse questionnaire enabled residents to evaluate the seminar and assessed new knowledge and skill acquisition. RESULTS Seventy-eight residents completed the precourse and postcourse questionnaires. The vast majority of respondents indicated that they taught medical students (72 of 78 [92.3%]). Approximately 20% of residency programs (17 of 78) provided residents with formal didactic programs on teaching skills. Fewer than half (46.8%) of the resident respondents indicated that they received feedback on their teaching from attending physicians (36 of 77), and only 18% (13 of 78) routinely gave feedback to their own learners. All of the course participants agreed or strongly agreed that this workshop was helpful to them as teachers. CONCLUSIONS Few residency programs had instituted resident teacher training curricula. A resident teacher training workshop was perceived as beneficial by the residents, and they reported improvement in their teaching skills.
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Affiliation(s)
- Andrea Donovan
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada.
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Smith DT, Kohlwes RJ. Teaching strategies used by internal medicine residents on the wards. MEDICAL TEACHER 2011; 33:e697-e703. [PMID: 22225453 DOI: 10.3109/0142159x.2011.611838] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Residents serve as teachers to interns and students in most internal medicine residency programs. AIM The purpose of our study is to explore what internal medicine residents perceive as effective teaching strategies in the inpatient setting and to formulate a guideline for preparing residents to lead their ward teams. METHODS Housestaff identified as excellent teaching residents were recruited from a large internal medicine residency program. Focus groups were formed and interviews were conducted using open-ended questions. Transcripts of the interviews were reviewed, analyzed, and compared for accuracy by two investigators. The transcripts were then coded to categorize data into similar subjects from which recurrent themes in resident teaching were identified. RESULTS Twenty-two residents participated in four focus group interviews held in 2008. We identified five principal themes for effective teaching by residents: (T)aking advantage of teaching opportunities, (E)mpowering learners, (A)ssuming the role of leader, (C)reating a learning environment, and (H)abituating the practice of teaching. CONCLUSION Strategies for effective teaching by residents exist. The TEACH mnemonic is a resident-identified method of instruction. Use of this tool could enable residency programs to create instructional curricula to prepare their residents and interns to take on the roles of team leaders and teachers.
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Amorosa JMH, Mellman LA, Graham MJ. Medical students as teachers: how preclinical teaching opportunities can create an early awareness of the role of physician as teacher. MEDICAL TEACHER 2011; 33:137-44. [PMID: 21275543 DOI: 10.3109/0142159x.2010.531154] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND As future physicians, questions about when medical students realize they will have to teach remain under-explored. AIM To understand when students serving in pre-clinical teaching roles make the connection between teaching and being a physician. METHODS Medical students involved in a peer instruction program included: (1) archived first-year student interview candidate data (n = 60/150); (2) focus groups of first-year students selected as instructors (n = 16/60); and (3) focus groups of second-year students (n = 16/24) who taught for the program. A modified extended-term mixed-method research design involved data from the pre-hire interviews and post-hire focus group. RESULTS Prior to teaching, none of the first year interviewees made an explicit connection between teaching and being a physician. The new instructors selected to teach minimally made a connection and only after prompting. The majority of the experienced instructors did make the connection; however, and did so spontaneously. CONCLUSION It was only after they taught medicine-related material that students saw the benefits of teaching as a way of preparing for becoming a physician and not merely as a way to review or help their peers.
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Affiliation(s)
- Jennifer M Harms Amorosa
- Department of Obstetrics and Gynecology, Division of Graduate Medical Education, College of Physicians and Surgeons, Columbia University, 622 W. 168th Street, PH 16, New York 10032, USA.
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The Obstetrics and Gynaecology Resident as Teacher. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2010; 32:1176-1185. [DOI: 10.1016/s1701-2163(16)34743-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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